UPDATE: Missouri governor resists expanding state-supported health insurance coverage

Tuesday, November 24, 2009 | 4:23 p.m. CST

ST. LOUIS — Gov. Jay Nixon is resisting a plan that could provide health insurance to thousands of Missouri children despite running for office on a pledge to expand health care access.

A federal law urges states to check for low-income families who are using state services but not currently enrolled in Medicaid. The data would allow states to automatically enroll children eligible for Medicaid.

Officials estimate that under the plan, 27,500 Missouri children would gain coverage and that it would cost the state nearly $33 million annually.

The St. Louis Post-Dispatch reported Tuesday that Nixon's office is troubled by the cost of the plan and doesn't intend to pursue it now. Nixon spokesman Jack Cardetti said the Democratic governor wants to see what Congress does with proposed health care legislation before moving on state efforts.

"It's an expensive option," Cardetti said. "The question is when can you do it."

State revenues have declined sharply this year, forcing hundreds of millions of dollars in budget cuts across state government.

On the campaign trail last year, Nixon criticized Republican Gov. Matt Blunt for cuts made in 2005 to Missouri's Medicaid program. Nixon promised to increase enrollment efforts and simplify the process, "so we get all these kids who are already eligible."

Child welfare advocates argue that the state saves money by insuring children because it cuts down on hospital emergency room visits, which are more expensive.

Ruth Ehresman, director of health and public policy for the Missouri Budget Project, said the Republican-controlled legislature has blocked some attempts to expand health care but that the governor is responsible for failures too. The Missouri Budget Project analyzes state budgets for their effect upon the poor and advocates for more spending on social services.

"There are some things he can do that he doesn't need the Legislature to approve," she said. "And he's dragging his feet on those, too, because of the budget difficulties."

Even without extra effort, enrollment in Missouri's Medicaid program has increased significantly this year. From January through September, the program added 41,505 people — more than two-thirds of which are children.

Missouri has made one change to help health clinics provide care. A 2008 law allows rural clinics and federally funded health centers to provide immediate, temporary coverage for low-income children while their eligibility is being reviewed.

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